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Objective / Description

In the German long-term nursing care system, additional reimbursement for care of home-dwelling persons with dementia is offered. This care does not include nursing care (separate reimbursement) and is usually offered by persons without formal education or qualifications in the field. These persons are employed by community care services.

Such care staff is trained in the promotion of physical activity in this group of persons. The aim is that care staff feels comfortable encouraging people to exercise safely. The basic thought is to enable non-specialists to demonstrate simple exercises. More so, the course intended to empower care staff to help older people with daily physical activity.

Learning objectives for care staff:
  • Effects of physical activity and exercising on the human body in old age
  • Knowledge on interactions between physical activity and dementia
  • Learning a simply exercise program that helps to improve strength and balance; performing and guiding of exercises with persons with dementia
  • Feeling safe while supporting simple transfers (getting up from chairs), walking, climbing stairs


  • Developing training sessions, consisting of 4 half-days plus creating training material, participant documentation and illustrated exercise catalog (exercises derived from Otago-Exercise Program)
  • The target group identification and the concept were based on discussions with various ambulatory nursing services. Subsequently, those services were contacted by mail and invited to name participants
  • In consultation with the local community nursing services, the first dates were set and spread over 3 months
  • For regular attendance, the fee of 160 Euro was waived (at least 3 of 4 dates)

Stakeholders and their tasks

  • Project employees: Design and implementation of training sessions (physiotherapist/lecturer in field of fall prevention and geriatric specialist)
  • Municipality's department for older people: Provision of premises, advertising
  • Outpatient nursing services: Involvement in design, naming participants


Expenses / Time

  • Design and preparation of training
  • Implementation of training (with 2 project employees at each date)
  • Premises
  • Copies / Media


In total, 14 registrations and 1 cancellation on short notice.

Experiences / Advice

  • 13 participants registered - employees of 3 community outpatient services.
  • The time spent at the course was paid as working time only for few of the participants - most participants visited the training during their spare time (high level of motivation).
  • Most participants had not been part of a longer training for their profession as care staff so far - they expressed the wish for further training courses, especially concerning the topics of dementia and communication.
  • Some participants considered the duration (4 hours) too long; the teachers had the same impression.
  • The course was evaluated by 11 participants (with a total of 25 clients): The contents were received as interesting and new, and the material as illustrative and appealing. They stated further that they had fun doing the exercises and that they would recommend the course.
  • 6 of 11 participants said that they had done exercises with a client by the time the course had finished. Only 3 participants did standing exercises, while the others had chosen sitting ones.
  • Frequently stated problems while implementing the course's contents: (1) client is not able to stand; (2) not possible to motivate client. Less frequent: (1) concern to harm client (e.g. by a fall); (2) lack of opportunity for implementation.
  • Conclusion: To ensure a practical implementation it would be desirable to be able to mentor the practical work. In general, there is great potential in this area, yet nursing services show little interest in further education for care staff.